Provider Demographics
NPI:1629392089
Name:DAVIS, CYNTHIA LEVINE (MSPT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LEVINE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 LARCH VALLEY CT NE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-3662
Mailing Address - Country:US
Mailing Address - Phone:571-258-1326
Mailing Address - Fax:
Practice Address - Street 1:525 E MARKET ST STE B
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-4171
Practice Address - Country:US
Practice Address - Phone:703-443-6700
Practice Address - Fax:703-443-6702
Is Sole Proprietor?:No
Enumeration Date:2010-03-15
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305006307225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist